Highlights Physical activity (PA) of children during the early COVID-19 response in the US was decreased compared pre-pandemic, per parent report. Changes in physical activity varied by age, with the largest changes seen in high-schoolers and less impact in preschoolers. Overall, children across all age groups were reported to have less community-based and peer PA during the pandemic, which aligned with social distancing guidelines at the time. Community leaders, educators, and parents are reminded to make PA a priority to assure children continue to receive the levels of activity necessary to promote good health.

Background: The purpose of this study was to assess function, at the age of 10 years, of children initially treated nonoperatively for clubfoot with either the Ponseti or French physiotherapy program and to compare outcomes in feet that had undergone only nonoperative treatment with those that required subsequent surgery. Methods: Gait analysis, isokinetic ankle strength, parent-reported outcomes, and daily step activity data were collected when patients who had been treated for idiopathic clubfoot reached the age of 10 years. Patients who had undergone only nonoperative treatment were compared with those who subsequently underwent extra-articular surgery or intra-articular surgery (posterior release or posteromedial release). The clubfoot groups were compared with age-matched controls. Results: Of 263 treated clubfeet in 175 patients, 148 had only been treated nonoperatively, 29 underwent extra-articular surgery, and 86 underwent intra-articular surgery (posterior release in 42 and posteromedial release in 44). Significant abnormalities were found in ankle kinetics and isokinetic ankle strength in the feet treated with intra-articular surgery compared with the nonoperatively treated feet (p < 0.017). Compared with controls (n = 40 feet), all groups showed reduced ankle plantar flexion during gait, resulting in a deficit of 9% to 14% for dynamic range of motion, 13% to 20% for ankle moment, and 13% to 23% for power (p < 0.013). Within the intra-articular group, feet that underwent posteromedial release had decreased plantar flexion strength (15%; p = 0.008), dorsiflexion strength (6%; p = 0.048), and parent-reported global function scores (p = 0.032) compared with the posterior release group. The patients with clubfoot took 10% fewer steps (p = 0.015) and had 11% less total ambulatory time (p = 0.001) than the controls. Conclusions: Examination of patients when they had reached the age of 10 years showed better ankle power and isokinetic strength for clubfeet treated without surgery compared with those that underwent intra-articular surgery for residual deformity or recurrence. Compared with controls, both nonoperatively and surgically treated clubfeet had significant limitations in ankle plantar flexion resulting in decreased range of motion, moment, and power. Gastrocnemius-soleus complex strength was decreased after both nonoperative and surgical treatment of clubfeet. Although activity was diminished in the clubfoot population, no differences in function were perceived by the patients’ parents. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Assessment of physical, ambulatory, activity using accelerometer-based devices has been reported in healthy individuals across a wide range of ages, as well as in multiple patient populations. Many researchers who utilize the StepWatch Activity Monitor (SAM) rely on the default settings for data collection and analysis. A comparison was made between the standard output from the SAM software, and a novel method to evaluate all walking bouts using an Intensity-Duration-Volume (I-D-V) model in healthy children aged 7-13. 105 children without impairment wore the SAM for a total of 1691 d. Statistically significant differences were seen between 7-8-9 year olds and 10-11-12 year olds using the I-D-V model that were not seen using the standard SAM software default output. The increased sensitivity of this technique could be critical for observing the effect of various interventions on patients who experience physical limitations. This new analytical model also allows researchers to monitor activity and exercise-type behavior in a way which coincides with exercise prescription by assessing intensity, duration and volume of activity bouts.

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Objectives Guided by the social ecological model, this study aimed to examine the relations of built environments (i.e., walking/cycling infrastructure, recreation facilities, neighborhood safety/crime), youth's transition abilities, and changes of youth's physical activity (PA) and play behaviors due to COVID-19-based restrictions. Ethnic and socioeconomic status (SES) disparities were also examined on studies variables during the COVID-19 restrictions. Method A cross-sectional research design was used to assess an anonymous online survey completed by US parents/guardians. The final sample had 1324 children and adolescents (Mean age = 9.75; SD = 3.95; 51.3% girls), and 35.5% the families were of upper socioeconomic class (income > $150,000). Parents reported the perceived built environment and neighborhood safety, child's PA and play behaviors during COVID-19 pandemic shelter-in-place restrictions. Results Youths who had access to safe built environment were more active and played more outdoor/indoor (p < .01). It was found playing behavior in yard and neighborhood were significantly increased, but community-based play behavior was significantly reduced during COVID-19 restrictions. The SEM analysis (χ 2 /df = 236.04/54; CFI = .966) supported indirect and direct effects of neighborhood safety on PA changes during COVID-19 restrictions, and the youth's ability to respond to COVID-19 restrictions served as a full mediator. Low-SES and Hispanic minority youth reported significantly less safety to walking or playing in their neighborhoods than their middle-/high-SES non-Hispanic peers (p < .001). Regardless of ethnicity, the magnitude of the reduction of MVPA was significantly higher among low-SES groups than that of the high-and middle-SES groups (p < .001). Conclusions These findings demonstrate a need to tailor programs and policies to help high-risk groups (e.g., low SES) stay active, healthy, and resilient during and after the COVID-19 pandemic.